Healthcare Unfiltered

Krishna Komanduri (@drkomanduri), MD, chief of the division of transplantation and cellular therapy, University of Miami Sylvester Comprehensive Cancer Center, joins the show to provide a fascinating account of the history of allogeneic and autologous transplantation, the discovery of the difference between B cells and T cell, and up through modern cellular therapy with a forecast for the future decades. This is a crash course in cellular and CAR-T therapy that you won’t want to miss.

Chadi invites Amy Barhorst (@amybarnhorst), MD, and Rocco Pallin, colleagues at UC Davis Health, to tackle the stigma and underdiagnosing of mental health in America and how mental illness intersects with gun violence in this country. The experts delve into whether community and person-to-person violence should be largely attributed to mental illness as well as why policy changes are the clearest way to eliminate mass shootings. Then, the conversation pivots to a true story of how their Review article on ways HCPs can help prevent injury and suicide from firearms was rejected and then plagiarized by the journal editor, all of which was all covered in a viral Twitter thread.View Dr. Barnhorst's interview with CNN on whether shootings are a mental health issue https://www.cnn.com/videos/tv/2018/11/27/exp-gps-1125-gupta-barnhorst-mental-health-guns.cnnRead Dr. Barnhorst's op-ed in the New York Times on why the mental health system cannot stop mass shooters https://www.nytimes.com/2018/02/20/opinion/mental-health-stopping-mass-shooters.html

Aziz Nazha (@AzizNazhaMD), MD, former hem/onc at Cleveland Clinic, self-taught computer science expert, and now practice manager in the Data and Machine Learning Team at Amazon Web Services, joins the show to discuss artificial intelligence (AI) and machine learning from an entirely unique perspective. He details the pitfalls of unstructured healthcare data, privacy and ownership issues related to healthcare data and whether hospitals should be allowed to sell their patient data, why AI lagged in the healthcare industry compared to other industries, whether AI will ultimately replace physicians, and many other topics.

Chadi is joined by Priya Sampathkumar (@PSampathkumarMD), MD, infectious disease specialist and hospital epidemiologist, Mayo Clinic, to detail the COVID vaccine effort over the past 12 months and how the currently approved ones came to be safe and effective in such a short period of time. She then compares each vaccine in relation to their clinical trials and study populations, side effects (including some rare ones), and efficacy. Chadi and Dr. Sampathkumar converse on what it will take for herd immunity to be reached in the US, how worried we should be about the virus variants, proper precautions to be taken after vaccination, and so much more.

Andrew Foy (@AndrewFoy82), MD, cardiologist at Penn State University, joins the show to discuss publishing bias for medical research along with the psychological dilemma as a result of the pandemic of sacrificing personal liberties for the safety of others. The conversation pivots to Dr. Foy’s experience with boxing at a young age and how he eventually channeled that love into promoting the sport. How can promoting a boxing match be similar to planning a wedding? How can a full-time cardiologist balance his time while also promoting boxing matches? Dr. Foy provides a peek into the boxing world and the way COVID has impacted the sport in this riveting interview.

Toni Choueiri (@DrChoueiri), MD, Dana-Farber Cancer Institute, joins the show to guest host a discussion with Rana McKay (@DrRanaMcKay), MD, UC San Diego, and Alicia Morgans (@CaPsurvivorship), MD, MPH, Northwestern University, on the practice-changing abstracts presented at the 2020 ASCO-GU virtual meeting. The trio weigh the importance and real-world implications of the ACIS study for mCRPC, EV-301 for advanced or metastatic urothelial carcinoma as well as CheckMate 274 for muscle-invasive disease, CLEAR for first-line treatment of advanced RCC, and so much more.

Chadi welcomes back Jack West (@JackWestMD), MD, associate clinical professor and medical oncologist, City of Hope Comprehensive Cancer Center, and Nathan Pennell (@n8pennell), MD, PhD, thoracic medical oncologist, director of the thoracic oncology program and director of clinical research, Cleveland Clinic, to the show. The task was to break down the ADAURA trial again, but to go beyond ADUARA and explore the use of various endpoints in lung cancer and how trials should be optimally designed to assure that patients garner the benefits that they deserve. The trio uses this discussion to contextualize a debate on the FDA lowering vs raising regulation on adjuvant therapies and whether the FDA should simply make drugs available and encourage physicians to use their best clinical judgment when prescribing them. ADAURA is only one study, but there are so many lessons that can be learned from the trial that can benefit current and future trial design.View Dr. West’s JAMA viewpoint on the ADAURA trial https://jamanetwork.com/journals/jamaoncology/article-abstract/2775933View Dr. Pennell’s opposing JAMA viewpointhttps://jamanetwork.com/journals/jamaoncology/fullarticle/2775934

David Fajgenbaum (@DavidFajgenbaum), MD, MBA, MSc, assistant professor in the department of medicine at the University of Pennsylvania, as well as the associate director of patient impact for the Penn Orphan Disease Center, joins the show to talk about his experience writing and receiving feedback on the national bestseller “Chasing My Cure” as a survivor of Castleman disease – a commentary on how he turned hope into action and discovered an old drug that had never been researched in Castleman disease into a personal life-saver. Dr. Fajgenbaum then details the Cure Drug Repurposing Collaboratory, a public/private relationship between the FDA, the NIH, the Critical Path Institute, and academics like himself with the goal of identifying drugs with approved indications in one disease that have efficacy in other diseases. Additionally, he shares the work of the CORONA Project, the COVID-19 registry of new and repurposed agents that seeks to record any drug given to any patient with COVID-19 for the purposes of research and understanding the disease.View Dr. Fajgenbaum’s viral Tik Tok https://twitter.com/DavidFajgenbaum/status/1354478246826569728View Chadi’s book review of “Chasing My Cure” https://thehealthcareblog.com/blog/2019/12/16/chasing-my-cure-a-book-review/

Vincent Rajkumar, (@VincentRK), MD, hematologist at the Mayo Clinic (Rochester, MN), joins the show to guest host a debate between Sagar Lonial (@SagarLonialMD), MD, FACP, chief medical officer of Winship Cancer Institute of Emory University, and Rafael Fonseca, (@Rfonsi1), MD, interim director of Mayo Clinic Cancer Center. These multiple myeloma “gurus” dive into imaging, smoldering disease, endpoints, maintenance, minimal residual disease, and so much more.

Tanios S. Bekaii-Saab (@GIcancerDoc), MD, professor of medicine and director of the GI oncology program at the Mayo Clinic (Phoenix, AZ), joins the show to highlight the research with significant clinical application presented at the virtual ASCO-GI meeting, including KEYNOTE-177 and ATOMIC in colorectal cancer, atezolizumab plus bevacizumab for first-line HCC, a survival update in the POLO trial and utility of radiation for pancreatic cancer, PD-1 inhibitors for first-line and adjuvant treatment of gastric cancer, and much more.